Worker Interview - DSA

Worker Interview

General Information

Project Name: Lamar High School - HISD

Prime Contractor: Gilbane Building Company

Subcontrctor: Momentum Exterior Systems, LLC

Interview Detail

Date

Worker Name

Auditor Name

Remarks

03/01/2019 02:02 PM

Carlos Cortillo

Jorje Munoz

None

ethnicity

gender

ssn

badge

Hispanic

Male

2056

No

Job Classification

Union Member?

Apprentice?

Period

Glaziers

No

No

8

Start Date

Last Work Date

Hours Last Worked

Pay Rate

02/21/2019

02/28/2019

8.00

15.50

Pay Type

Pay Day

deductions

OSHA

Paycheck

Friday

No

No

Misc Details

Tools 1

Tools 2

Tools 3

Tools 4

Drills

Knife

Screw Gun

None

Provides Tools?

Provides Materials?

Worked Overtime?

Hours Last Week

Yes

No

No

16.00

Other Work?

Other Training?

Experience

Certifications

None

None

1.00

Boomlift and scissor lift

Aware of Postings?

Threatened?

No

No

Signatures

Employee Signature

Auditor Signature